By Reg Jones
Medicare coverage
February 8th, 2012 | Medicare
Q: Dialysis for End Stage Renal Disease is covered by Medicare. Is it Part A or Part B that covers this treatment?
A: Part A for regular dialysis, Part B for chronic dialysis.
Tags: Medicare
Part B requires premium payment
February 1st, 2012 | Benefits HEALTH INSURANCE Medicare SOCIAL SECURITY
Q. My mother just came to me and showed me her Social Security statement. She asked: “Why are they deducting $96.50 for monthly Medicare insurance when I have full medical coverage from the Navy?” She is an 86-year-old Navy veteran, and my father, who passed away three years ago, was retired from the Navy. Is this something she should be paying?
A. She appears to have signed up for Medicare Part B (medical insurance), for which she would be required to pay the premiums.
Figuring out primary, secondary coverage
January 31st, 2012 | Coverage after retirement FEHBP and Medicare HEALTH INSURANCE Medicare RETIREMENT
Q. I plan to retire in a few years. I am currently 67 years old, participate in the Federal Employees Health Benefit Plan with Blue Cross Blue Shield and am enrolled in Medicare Part A, which is free and required at 65. I do not wish to participate in Medicare Part B because, from the way I see it, I would be paying for two primary insurers even when I retire. Am I entitled to continue with my FEHB as my primary coverage, and would I be entitled to the same choices as though I were still working for the government? I feel that Blue Cross is the better of the two coverages and Medicare Part B and my portion of my Basic Plan with BCBS is about the same cost to me and Blue Cross is readily accepted by all doctors.
A. Once you retire, Medicare Part A will be primary and your FEHB plan secondary. If you don’t enroll in Medicare Part B, your FEHB plan will be your only coverage, but it won’t pay benefits in the same way it did when you were employed. How that is done is explained on pages 24 and 25 of your 2011 Blue Cross and Blue Shield Service Benefit Plan brochure.
Part B decision depends on costs, benefits
January 31st, 2012 | Coverage after retirement FEHBP and Medicare HEALTH INSURANCE Medicare RETIREMENT
Q. I am 62, and will be retiring from the Postal Service within three months, rather unexpectedly. We will be continuing with my current Blue Cross Blue Shield plan for annuitants. My wife is 65, and declined Medicare Part B since I was still working. Will it be necessary for her to sign up for Part B, or will the continued Federal Employees Health Benefit plan suffice?
A. She doesn’t have to sign up for Medicare Part B. However, before she makes up her mind, the two of you need to weigh the potential costs and benefits of that decision. If you conclude that what is covered by your Blue Cross Blue Shield plan will be sufficient over time, she can decide not to elect Part B. On the other hand, if Part B offers complementary benefits and/or different ones that fill important gaps and reduce your out-of-pocket cost, even when considering the monthly premiums, then she can elect Part B.
Primary insurance depends on employment status
January 25th, 2012 | Creditable service: CSRS FEHBP and Medicare HEALTH INSURANCE Medicare RETIREMENT
Q. I have been receiving workers’ comp benefits since 1981. I have no Civil Service Retirement System benefits available, as I withdrew my contributions when I was separated from service. I am now 65 years old and have applied for Medicare. I have maintained my Blue Cross/Blue Shield insurance through the Office of Workers’ Compensation Programs. There is now a dispute as to whether that insurance is primary or Medicare is primary. The question seems to revolve around the following question: Am I “retired” or am I still employed? Do you know the answer?
A: Workers’ compensation is an income replacement program that is designed to continue until an injured employee recovers or dies, whichever comes first. If someone on workers’ comp recovers, he goes back on the agency rolls or, if he is eligible and wants to do so, retires. This tells me that you aren’t retired, a conclusion that is bolstered by the fact that you are not on OPM’s annuity roll and, therefore, not receiving an annuity. If I am right, then your Federal Employees Health Benefit plan carrier would continue to be the primary payer and Medicare secondary.
To keep, or not to keep, Part A
January 24th, 2012 | Benefits Coverage Medicare RETIREMENT SOCIAL SECURITY
Q. I am 68 and still working. I am fully covered by my employer’s insurance. My employer is switching our health insurance to a health savings account in 2012. You cannot contribute to a HSA if you have Medicare Part A. I have Medicare Part A. Should I drop Part A, to enroll in the HSA, or will I be penalized later when I retire and re-enroll in Part A?
A. I don’t know if it makes sense for you to disenroll from Medicare Part A. Before you decide, you need to understand a few things. First, if your employer contribution to your company HSA isn’t more than you would earn from Social Security, you may want to keep your Medicare Part A coverage. Second, because you have already turned 65, if you disenroll from Medicare Part A, you would have to pay back all of the money you received from Social Security, as well as any Medicare benefits that were paid on your behalf. To disenroll, fill out Centers for Medicare and Medicaid Services (CMS) form 1763 (Request for Termination of Premium Hospital and Medical Insurance) and mail to your local Social Security Administration office. You can re-enroll at any time by calling Social Security at 1-800-772-1213 or visiting your local SSA office.
Part A not mandatory, but smart to have
January 18th, 2012 | HEALTH INSURANCE Medicare RETIREMENT
Q. I turned 65 on July 6, 2011. I was advised prior to my birthday that I did not need to sign up for Medicare Part A until my retirement in July 2012. Is this correct? I am covered by a group policy at this time.
A. While you don’t need to sign up for Medicare Part A, I can’t think of any reason why you wouldn’t want to do that. Although you will continue to have deductions taken from your salary to pay for that benefit, you wouldn’t have to pay any premiums for that coverage. If you did sign up while working, your group plan would be the primary payer and Medicare Part A the secondary one. The combination of these two benefits often fills in gaps that each have. Further, they usually reduce the amount of co-insurances and deductibles you’d have to pay.
Will FEHB plan cover wife?
January 17th, 2012 | Coverage after retirement FEHBP and Medicare HEALTH INSURANCE Medicare
Q. I am a Civil Service Retirement System retiree approaching age 65. My wife and I have been covered by Blue Cross/Blue Shield Standard Option FEHB since retiring in 2002. My wife will not be eligible for Medicare until 2013, and she has never been employed by the federal government. Do I maintain my Federal Employees Health Benefit plan for both of us in order for her to be covered? Or is there some provision that will permit me to pay a Medicare Part B premium for my portion of the health care coverage out of my annuity while maintaining her FEHB full health insurance premium?
A. The only way she can continue to be covered by your FEHB plan is for you to continue being enrolled in the self-and-family option. If you additionally elect to be covered by Medicare Part B, those premiums can be deducted from your annuity.
Compare Part B, FEHBP to decide which is appropriate
January 17th, 2012 | FEHBP and Medicare HEALTH INSURANCE Medicare
Q. I am a federal annuitant and have Federal Employees Health Benefit Plan 105 for myself and my spouse. We also subscribe to Medicare Part B. Since there are overlaps between Medicare Part B and FEHBP, I am considering stopping Medicare Part B. How do I do a cost-benefit analysis of retaining vs. stopping Medicare Part B? Also, please let me know about which state and federal help agents I can approach.
A. To the best of my knowledge, there isn’t any publication or software that will allow you to do a cost-benefit analysis. There are simply too many variables. You’re going to have to make a decision based on your own comparison of the coverage offered by the two and their relative cost. Just remember that what you need in the way of coverage today may not be the same as what you need later on. Further, if you drop your Medicare Part B coverage and later realize that you need it, when you re-enroll you will be penalized for every year you could have been enrolled and weren’t. Note: While there is no source of information that will meet all your needs, OPM has a pamphlet called called “The Federal Employees Health Benefits Program and Medicare” that you might find helpful. You’ll find it at http://www.opm.gov/insure/archive/health/medicare/75-12-FINAL.pdf.
Medicare eligibility
January 16th, 2012 | Medicare SOCIAL SECURITY
Q. I am 64 and don’t have enough credits to get Social Security. I will turn 65 in October. Will I be eligible for Medicare? If not, do I still sign up for it? My husband retired from Ford Motor Company and is 61. He will turn 62 in April. He plans on getting on Social Security at that time. Will I then be able to get Medicare?
A. The answer to both questions is no.